Besides, the expression ofcannabinoid 1 (CD-1) is suppressed, which has the potential to act on tightjunction proteins, resulting in the development of “leaky gut.” By thisprocess, LPS from gram-negative bacteria enters the body circulation,contributing to an antigen-antibody reaction that activates the immune system,induces chronic inflammation, impairs the function of insulin receptors, andthereby increases the level of insulin, resulting in elevated androgen levelsand irregular follicular development leading to PCOS [153]. Here, INS is linked to polycystic ovary syndrome.